Ovarian Cancer

Can Talcum Powder Cause Ovarian Cancer? What Women Need to Know

Washington, D.C., September 27, 2017 - A handful of multi-million dollar jury awards to women who used baby powder with talcum, and later were diagnosed with ovarian cancer, has highlighted a decades-old question: Does talcum powder really cause ovarian cancer?

Louis Dainty, MD, regional director of gynecologic oncology, MedStar Washington Hospital Center, says even though the scientific data is very weak, women should not take the risk, however slight.

Because there is the potential for a very small increased risk of ovarian cancer with the use of talcum powder, I recommend women not use baby powder in their genital area,” he said. “If a woman has used talcum powder for these purposes, even for years or decades, she doesn’t need to run to her doctor or get special testing. Instead, just stop using the product.”

Dainty advises patients who have or care for daughters in diapers to avoid talcum powder on them. An alternative is dusting the baby with baby powder products made with cornstarch.

The possible link between ovarian cancer and talcum powder dates back to the 1960s. The initial concern sprung from a contamination of talcum powder with asbestos, a known cancer-causing agent. Asbestos is often mined alongside the mineral talc, which is the main ingredient in talcum powder. Asbestos was banned from cosmetic-grade talc in 1973, and the Food and Drug Administration reported finding no traces of asbestos in talc-based cosmetic products in 2012.

Recent studies looking at a potential link between talcum powder and ovarian cancer have been inconclusive, Dainty said. Some show a slightly increased risk, and others report no increase at all.

One criticism with many of these studies is that they relied on people’s memory of their talcum powder use. Researchers asked women with ovarian cancer if they used talcum powder on their perineum and, if so, how long they had used it and how frequently. Memory is not always perfect.

An issue of great concern is there is no screening test for ovarian cancer, like the Pap test for cervical cancer. A woman’s risk of developing ovarian cancer in her lifetime is 1.6 percent. Some studies suggest that risk rises to 1.8 percent with perineal talc exposure. That translates to 18 women out of 1,000 developing ovarian cancer instead of 16. “While that may not sound like a lot,” Dainty said, “that’s two women who may not have gotten ovarian cancer if they had avoided talcum powder.”

Without a screening test, women must rely on monitoring themselves for the following symptoms, and see a gynecologist if they persist for two weeks.

Abdominal or pelvic pain

Bloating

Difficulty eating or feeling full quickly

Unexplained weight gain

The main risk factor for developing ovarian cancer is age. The average age of a woman with ovarian cancer is 63. The older women get, the higher their risk for developing the disease.

The most commonly talked about ovarian cancer risk is familial risk, or a disease that runs in the family. While most ovarian cancers are not hereditary, family history certainly is very important. Genetic mutations, such as BRCA1 and BRCA2, account for about 15 percent of all ovarian cancers.

If a first-degree family member—parents, siblings or children—had ovarian cancer or breast cancer before age 50, women may want to consider seeing a geneticist to determine their potential risk. Breast cancer is also included because BRCA1 and BRCA2 mutations increase a person’s risk for multiple cancers, including breast and ovarian.

“There’s nothing you can do about getting older or your genetic makeup, but you can do something about your weight, which is the No. 1 modifiable risk factor for ovarian cancer,” Dainty said. “If you are 25 pounds overweight, your ovarian cancer risk rises 400 percent. So while talcum powder may slightly increase your risk of ovarian cancer, it’s minimal compared to the risk of carrying extra weight.”

Talcum powder has long been a baby care and personal hygiene essential, showing up in everything from cosmetics to soaps to antiperspirants. It’s best known as an ingredient in baby powder, which has been used to keep babies’ and adults’ bottoms dry and odor-free since the 1800s.

Women have historically used talcum powder on these areas to absorb vaginal moisture and odor. However, this practice has waned with younger generations, so it’s usually older women who use it this way.

But the use by adult women has recently thrust the product into the media spotlight. A jury in August 2017 awarded a woman $417 million in a case against Johnson & Johnson. The woman claimed her terminal ovarian cancer was caused by the company’s baby powder, which she said she’d used for decades on her perineum, which in a woman is the area from the outer genitals (vulva) to the anus.

The case reignited a decades-old question: Can talcum powder cause ovarian cancer if used in the genital area? Studies and the experts are mixed on the issue. Certainly there are other more significant risk factors for ovarian cancer. But because of the potential for a very small increased risk of ovarian cancer with the use of talcum powder, I recommend women not use baby powder in their genital area.

Tune in to this podcast to hear Dr. Louis Dainty further discuss the potential link between talcum powder and ovarian cancer.

What studies say about talcum powder and ovarian cancer

The possible link between ovarian cancer and talcum powder dates back to the 1960s. The initial concern sprung from a contamination of talcum powder with asbestos, a known cancer-causing agent. Asbestos is often mined alongside the mineral talc, which is the main ingredient in talcum powder. Asbestos was banned from cosmetic-grade talc in 1973, and the Food and Drug Administration reported finding no traces of asbestos in talc-based cosmetic products in 2012.

Recent studies looking at a potential link between talcum powder and ovarian cancer have been inconclusive. Some show a slightly increased risk, and others report no increase at all.

One problem with many of these studies is that they relied on people’s memory of their talcum powder use. Researchers asked women with ovarian cancer if they used talcum powder on their perineum and, if so, how long they had used it and how frequently. Memory is not always perfect.

A woman’s risk of developing ovarian cancer in her lifetime is 1.6 percent. Some studies suggest that risk rises to 1.8 percent with perineal talc exposure. That translates to 18 women out of 1,000 developing ovarian cancer instead of 16. While that may not sound like a lot, that’s two women who may not have gotten ovarian cancer if they had avoided talcum powder.

How I advise women about using baby powder on themselves and babies

While statistically the potential increased risk is very small, we want to do everything we can to reduce a woman’s risk for developing ovarian cancer. That’s why I recommend women not apply talcum powder on their sanitary napkins, diaphragms or directly to their genital area.

If you’ve used talcum powder for these purposes, even for years or decades, you don’t need to run to your doctor or get special testing. Instead, just stop using the product.

I advise patients who have or care for daughters in diapers to avoid talcum powder on them as well. While we know little for sure about the ovarian cancer risk to adults who use baby powder, we know even less about the potential risk to babies. If I had babies again, I probably would not use talcum powder on their bottoms. If you want an alternative, try dusting your baby or yourself with cornstarch instead.

When my patients ask if they should douche or use other vaginal hygiene products, I tell them that the vagina is designed just as it should be and should be messed with as little as possible. I don’t recommend the use of any artificial products that you don’t absolutely need. And if you do use them, find the product with the least number of additives, such as coloring or perfume.

Know the symptoms and other risk factors for ovarian cancer

Ovarian cancer is known as a “silent killer” because most women will not experience symptoms until the disease is advanced.

Symptoms of ovarian cancer can include:

Abdominal or pelvic pain

Bloating

Difficulty eating or feeling full quickly

Unexplained weight gain

These symptoms can be attributed to a variety of conditions, including normal body changes that occur during a woman’s menstrual cycle. But if they suddenly appear and don’t go away, request an appointment with your doctor.

The main risk factor for developing ovarian cancer is age. The average age of a woman with ovarian cancer is 63. The older you get, the higher your risk for developing the disease.

The most commonly talked about ovarian cancer risk is familial risk, or a disease that runs in the family. While most ovarian cancers are not hereditary, family history certainly is very important. Genetic mutations, such as BRCA1 and BRCA2, account for about 15 percent of all ovarian cancers.

If a first-degree family member—parents, siblings or children—had ovarian cancer or breast cancer before age 50, you may want to consider seeing a geneticist to determine your potential risk. We include breast cancer because BRCA1 and BRCA2 mutations increase a person’s risk for multiple cancers, including breast and ovarian.

There’s nothing you can do about getting older or your genetic makeup, but you can do something about your weight, which is the No. 1 modifiable risk factor for ovarian cancer. If you are 25 pounds overweight, your ovarian cancer risk rises 400 percent. So while talcum powder may slightly increase your risk of ovarian cancer, it’s minimal compared to the risk of carrying extra weight.

We may never know for sure whether talcum powder absolutely can cause ovarian cancer, but not using it on your genital area is an easy way to avoid the potential risk. If you’re concerned about your risk for ovarian cancer, talk to your doctor. Together, you can work out a plan to manage your risk factors and feel comfortable with your feminine hygiene.

My life has been overflowing with Love and Luck, and never more so than since my surprise diagnosis of advanced ovarian cancer on March 12, 2001, at age 45 years, five months and 19 days.

Although my 68-year-old mother had died of advanced-stage ovarian cancer exactly five months earlier, on Oct. 12, 2000, there was no other history of ovarian cancer in my family. We are not carriers of the infamous mutated BRCA genes (go ahead, Google Angelina Jolie!), which, when in good working order, protect against ovarian and breast cancer. When those genes are damaged, they no longer offer protection, and the chance of a woman being diagnosed with ovarian or breast cancer is as high as 80 percent. In my case, with no BRCA mutation, we simply don’t yet know what we don’t know.

Despite decades of research for an effective and inexpensive screening test for all women as part of an annual checkup, there is no screening test for ovarian cancer. No simple blood test. No scan. No X-ray. No test like a Pap smear, which is so effective for diagnosing early-stage cervical cancer.

That someone like me – who was carefully monitored during my mom’s nine-month illness – could be diagnosed late stage should be very disturbing to anyone who is a woman, or who knows a woman. And, that would be everyone, right?

Surviving Cancer

Luck has been my buddy for more than 15 years of my healthy survivorship. I have no clue why I obliterated the odds of surviving five years, much less 15. A vegetarian for five years before my diagnosis, I craved bacon during chemo, caved to the temptation, and have never looked back. I have come to believe bacon goes with everything.

I love the “love” in my beautiful Love and Luck duo, because I have been blessed beyond measure with a husband who has had my back at every turn for way longer than 15 years, and especially since that fateful diagnosis day. Too many people suffer the emotional loss of a spouse or partner who simply “can’t handle” illness and survivorship. I say, if they think they can’t handle it, they should step into the shoes of those going through it and imagine how hard it is. Lucky me, to have him.

My survivor sisters, well, where would I be in my survivorship journey without them? I joined an online support group when Mom was diagnosed, to get tips and tricks from survivors to help her. When I returned to the group on my own behalf, I was welcomed like a long-lost daughter. Survivors meet every year at the Ovarian Cancer Research Fund Alliance conference, and a core group of us have become close friends, even choosing to vacation together annually for a long girlfriend weekend. We have a blast when we reunite. We are stronger together.

We urge one another to stay active in ovarian cancer education and advocacy, from sharing our diagnosis stories with third-year medical students (Survivors Teaching Students: Saving Women’s Lives®) to being the survivor voice on government research and funding projects. We long-termers must stay involved, to give hope to women and to keep the pressure on for early detection and a cure.

I am lucky I now am old enough to feel the “joys” of an aging back, wrinkle my nose in disgust at age spots, and wonder when those fine lines around my eyes appeared.

I would love to know my secret survival sauce, because I would bottle it and give it away. I would send it to my two sweet and courageous friends who now are in hospice care at ages impossible to imagine. And, I would leap back in time and gift it to Mom and the countless friends whose love was so important to me before they were lost to ovarian cancer.

Symptoms of Ovarian Cancer – Sort Of

A woman should have a thorough gynecologic exam by a gynecologic oncologist if she experiences one or more of the symptoms listed for more than two weeks and are unusual for her. Please note, many women are diagnosed without having any symptoms. But, without a screening test, this is the best we have. Be vigilant!

Bloating

Feeling full quickly after eating

Pelvic or abdominal pain

Urinary symptoms (urgency or frequency)

A Snapshot of Ovarian Cancer (Source: National Cancer Institute)

Ovarian cancer accounts for approximately 3 percent of all cancers in women.

Ovarian cancer is the fifth leading cause of cancer-related deaths among women in the United States.

Approximately 22,000 women are diagnosed with ovarian cancer in the U.S., and approximately 14,000 will die of the disease.

75 percent of ovarian cancer is diagnosed at the advanced stages of III or IV, when it is harder to cure.

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